Makenzie Baker X, BS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fairfield, IL
NPI 1780053348 · NPPES record last updated Sep 24, 2015
Key facts
- NPI
- 1780053348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 407 N Basin Rd
Fairfield, IL 62837-9639 - Phone
- (618) 842-2125
- Fax
- (618) 842-4154
- NPI assigned
- Sep 24, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes | ||
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X |
Addresses
Primary practice location
407 N Basin Rd
Fairfield, IL 62837-9639
Mailing address
504 Micah Dr
Drawer M
Olney, IL 62450-4720
Phone (618) 395-4306
Other providers in Fairfield, IL
- Rebecca Anthony
- Aperion Care Fairfield LLC
- Aperion Care Fairfield LLC
- Mavis A Aslinger
- Katelyn Atteberry
- Christopher W Ballard
- Jill L Barnfield
- Vivian Beadles
- Christopher D Beehn
- Kayla Shaye Bell
All providers in Fairfield, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.